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The Effects of Age, Gender, Hopelessness, and Exposure to Violence on Sleep Disorder Symptoms and Daytime Sleepiness Among Adolescents in Impoverished Neighborhoods

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Abstract

Although sleep problems are associated with negative outcomes among adolescents, studies have not focused on sleep disorder symptoms among adolescents living in impoverished neighborhoods and how sleep problems may be related to two factors common in those environments: hopelessness and exposure to violence. This study used data from the longitudinal Mobile Youth Survey (MYS; N = 11,838, 49 % female, 93 % African-American) to examine trajectories of sleep problems by age (10–18 years) among impoverished adolescents as a function of gender, feelings of hopelessness, and exposure to violence. The results indicate that sleep problems associated with traumatic stress decline with age, with four notable distinctions. First, the steepest decline occurs during the early adolescent years. Second, the rate of decline is steeper for males than for females. Third, exposure to violence impedes the rate of decline for all adolescents, but more dramatically for females than for males. Fourth, the rate of decline is smallest for adolescents with feelings of hopelessness who also had been exposed to violence. To explore the generalizability of these results to other types of sleep disorders, we analyzed cross-sectional data collected from a subsample of 14- and 15-year-old MYS participants (N = 263, 49 % female, 100 % African-American) who completed a sleep symptoms questionnaire. Four results from the cross-sectional analysis extend the findings of the longitudinal analysis. First, the cross-sectional results showed that symptoms of apnea, insomnia, nightmares, and restless legs syndrome or periodic limb movement disorder (RLS/PLMD), as well as daytime sleepiness, increase as a function of hopelessness. Second, symptoms of insomnia, RLS, and nightmares, as well as daytime sleepiness, increase as function of exposure to violence. Third, symptoms of insomnia and RLS/PLMD are greater under conditions of combined hopelessness and exposure to violence than for either condition alone. Fourth, symptoms of RLS/PLMD are worst for females who have been exposed to violence and experience hopelessness. Overall, the findings suggest that hopelessness and exposure to violence have negative independent and multiplicative effects on adolescent sleep, particularly for females. Understanding the causal factors associated with inadequate sleep in impoverished adolescents is important for three reasons. First, sleep is an important aspect of adolescent development. Second, inadequate sleep has severe consequences for adolescent morbidity, mortality, and overall quality of life. Third, impoverished adolescents are at the most severe risk for poor outcomes, and improvement in their sleep may produce large gains.

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Acknowledgments

The research reported here was partially supported by the National Institutes of Health Office for Research on Minority Health through a cooperative agreement administered by the National Institute for Child Health and Human Development (HD30060); a grant from the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (TI13340); a grant from the National Institute on Drug Abuse (DA017428); a grant from the Southern Nursing Research Society; The University of Alabama; the Cities of Mobile and Prichard; the Mobile Housing Board; and the Mobile County Health Department.

Author contributions

MGU conceived the study, participated in its design and coordination, and drafted the manuscript; ACB participated in study design; managing data; and participated in drafting of the manuscript; KAB participated in drafting of the manuscript and interpreting of results; ST participated in analysis and interpretation of the data; and JMB participated in the study design and coordination, drafted the manuscript, and participated in analysis and interpretation of the data. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. School of Social Work, The University of Alabama, Tuscaloosa, AL, 35487-0314, USA

    Kathleen A. Bolland

  2. The University of Alabama, Tuscaloosa, AL, USA

    Mary Grace Umlauf & John M. Bolland

  3. Institute for Social Science Research, The University of Alabama, Tuscaloosa, AL, 35487-0216, USA

    Anneliese C. Bolland

  4. Department of Educational Studies in Psychology, Research Methodology, and Counseling, The University of Alabama, Tuscaloosa, AL, 35487-0232, USA

    Sara Tomek

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  1. Mary Grace Umlauf
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  2. Anneliese C. Bolland
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  3. Kathleen A. Bolland
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  5. John M. Bolland
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Correspondence to Kathleen A. Bolland.

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Umlauf, M.G., Bolland, A.C., Bolland, K.A. et al. The Effects of Age, Gender, Hopelessness, and Exposure to Violence on Sleep Disorder Symptoms and Daytime Sleepiness Among Adolescents in Impoverished Neighborhoods. J Youth Adolescence 44, 518–542 (2015). https://doi.org/10.1007/s10964-014-0160-5

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